This Menopause Awareness Month, Washington doctors are reminding people that heart disease is the leading cause of death for women, and that menopause can take a toll on heart health.

Research from the American Heart Association shows perimenopausal women are twice as likely to have low cardiovascular health scores as women with regular menstrual cycles.

Though the data is grim, obstetrician and gynecologist Dr. Ory Holtzman encourages people to look at menopause as a window of opportunity.

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"This is a great time to sit down with your clinician and review risk factors like your blood pressure, cholesterol, blood sugar – understand your long-term cardiovascular risk, and put into motion any plans for minimizing that risk," Holtzman said.

Holtzman explained when estrogen levels drop, it leads to changes in body composition – and within blood vessels – that can affect the heart.

Experts advise getting about 20 minutes of moderate exercise per day and eating a diet rich in plant-based foods to keep your heart healthy.

When it comes to lifestyle changes, Holtzman emphasized that it isn't "all or nothing." She recommends people start by understanding their risk factors and focusing on changes that have the biggest impact over time – like not smoking, exercising regularly and eating more whole foods.

"Remember that perfection isn't the goal, Holtzman noted. "It's increased awareness and making healthy changes, not a checklist where we are prescribed something and we have to do every single thing."

Holtzman added hormone therapy for menopause is neither universally bad for the heart, nor the right choice for everyone to protect against heart disease. She added that, while it can be an effective treatment for symptoms like hot flashes, it is not a one-size-fits-all solution.